Physiologic effects of electrical stimulation leg cycle exercise training in spinal cord injured persons.

The purpose of this study was to assess the physiologic training effects of functional electrical stimulation leg cycle ergometer (FES-LCE) exercise in persons with spinal cord injury (SCI) who were previously untrained in this activity. Ten persons with quadriplegia (C5 to C7) and eight with paraplegia (T4 to T11) performed FES-LCE training on an ERGYS I ergometer 10 to 30 minutes per day, 2 or 3 days per week for 12 to 16 weeks (36 total sessions). Training session power output (PO) ranged from 0.0W (no external resistance) to 30.6W. Each subject completed discontinuous graded FES-LCE and arm crank ergometer (ACE) tests before and after training for determinations of peak lower and upper extremity metabolic, pulmonary, and hemodynamic responses. Compared with pretraining, this SCI group exhibited significantly (p less than or equal to .05) higher posttraining peak PO (+45%), oxygen uptake ([O2], + 23%), pulmonary ventilation (+27%), heart rate (+11%), cardiac output ([Qt], + 13%) and significantly lower total peripheral resistance ([TPR], - 14%) during FES-LCE posttests. There were no significant changes in peak stroke volume (+6%), mean arterial pressure ([MAP], - 5%), or arteriovenous oxygen difference ([a-vO2diff], + 10%) during posttraining FES-LCE tests. In addition, no significant differences were noted for the peak level of any monitored variable during ACE posttests after FES-LCE training. The rise in total vascular conductance, implied by the significant decrease in posttraining TPR during FES-LCE tests, denotes that a peripheral circulatory adaptation developed in the persons with SCI during FES-LCE exercise training.(ABSTRACT TRUNCATED AT 250 WORDS)

[1]  I. Ringqvist,et al.  Physical conditioning and cardiovascular rehabilitation , 1981 .

[2]  J S Petrofsky,et al.  The use of functional electrical stimulation for rehabilitation of spinal cord injured patients. , 1984, Central nervous system trauma : journal of the American Paralysis Association.

[3]  D. Riley,et al.  The effects of inactivity, programmed stimulation, and denervation on the histochemistry of skeletal muscle fiber types. , 1973, Experimental neurology.

[4]  S. Figoni,et al.  Physiologic responses of SCI subjects to electrically induced leg cycle ergometry , 1988, Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[5]  J S Petrofsky,et al.  Functional electrical exercise: a comprehensive approach for physical conditioning of the spinal cord injured patient. , 1984, Orthopedics.

[6]  R. Gotshall,et al.  Impedance Cardiography: Noninvasive Assessment of Human Central Hemodynamics at Rest and During Exercise , 1989, Exercise and sport sciences reviews.

[7]  J. Petrofsky,et al.  Clinical evaluation of computerized functional electrical stimulation after spinal cord injury: a multicenter pilot study. , 1988, Archives of physical medicine and rehabilitation.

[8]  M. Yekutiel,et al.  The prevalence of hypertension, ischaemic heart disease and diabetes in traumatic spinal cord injured patients and amputees , 1989, Paraplegia.

[9]  R. M. Glaser,et al.  Pulmonary function changes in wheelchair athletes subsequent to exercise training. , 1982, Ergonomics.

[10]  K. Ragnarsson,et al.  Aerobic training effects of electrically induced lower extremity exercises in spinal cord injured people. , 1989, Archives of physical medicine and rehabilitation.

[11]  M. Pollock,et al.  Arm pedaling as an endurance training regimen for the disabled. , 1974, Archives of physical medicine and rehabilitation.

[12]  R. Patterson,et al.  Development and evaluation of an impedance cardiac output system. , 1966, Aerospace medicine.

[13]  R. Shephard,et al.  Current Therapy In Sports Medicine , 1994 .

[14]  L. Rowell Human Circulation: Regulation During Physical Stress , 1986 .

[15]  S. Hooker,et al.  Effects of low- and moderate-intensity training in spinal cord-injured persons. , 1989, Medicine and science in sports and exercise.

[16]  C. Mathias,et al.  Cardiovascular responses in tetraplegic man to muscle spasm, bladder percussion and head-up tilt. , 1975, Clinical and experimental pharmacology & physiology.

[17]  S. Figoni,et al.  Hemodynamic responses of quadriplegics to maximal arm-cranking and FNS leg cycling exercise , 1988, Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[18]  J. Maher,et al.  Measurement of cardiac output by electrical impedance at rest and during exercise. , 1976, Journal of applied physiology.

[19]  J. Clausen,et al.  Effect of physical training on cardiovascular adjustments to exercise in man. , 1977, Physiological reviews.

[20]  R. M. Glaser,et al.  Physiologic aspects of spinal cord injury and functional neuromuscular stimulation. , 1986, Central nervous system trauma : journal of the American Paralysis Association.

[21]  Physiologic responses to prolonged electrically stimulated leg-cycle exercise in the spinal cord injured. , 1990, Archives of physical medicine and rehabilitation.